Our insurance won’t pay for a test that confirmed my wife’s water had broke on the day our baby was born. The test was necessary because we had a planned C-section. The test confirmed that it had broke, so we moved forward with the C-section. It’s not like we were going to wait around until she went into labor, because that could complicate the birth.
I talked to the insurance company today. They denied our level one appeal, so I asked to escalate to level two. They say the test isn’t covered because there’s not proof that it improves health outcomes, but at the hospital this is standard procedure and really the only practical thing to do in our situation.
I get the sense that the level two appeal will also be denied, so our only hope will be the level three (final) appeal which is decided by a neutral third party.
What can we do to improve our chances of a successful appeal?
submitted by /u/Mrmonkeymind
[link] [comments]Our insurance won’t pay for a test that confirmed my wife’s water had broke on the day our baby was born. The test was necessary because we had a planned C-section. The test confirmed that it had broke, so we moved forward with the C-section. It’s not like we were going to wait around until she went into labor, because that could complicate the birth. I talked to the insurance company today. They denied our level one appeal, so I asked to escalate to level two. They say the test isn’t covered because there’s not proof that it improves health outcomes, but at the hospital this is standard procedure and really the only practical thing to do in our situation. I get the sense that the level two appeal will also be denied, so our only hope will be the level three (final) appeal which is decided by a neutral third party. What can we do to improve our chances of a successful appeal? submitted by /u/Mrmonkeymind [link] [comments]Read Morer/HealthInsurance